Patient-based medicine

Every day, we have to solve two questions: The first question is how to evaluate the severity of diseases affecting mainly the quality of life (psoriasis, acne, vitiligo, atopic dermatitis, genedermatosis...). This severity (the main information for selecting more appropriate treatments) is assessed by the patient but unfortunately the patient rarely has the expertise to make such assessments. The second question is to find a method to adjust the knowledge from the 'evidence based medicine', which is obtained by statistical population studies, to an individual patient, who will always be different and specific. The so-called "Patient Based Medicine" is the association of clinical techniques which can make it possible to solve these two questions. Patient Based Medicine unfolds in four phases: questions, explanations, negotiation (the most important step) and prescription. The goal of these successive phases is to take into account in the therapeutic choice all the aspects of the patient's characteristics: way of life, co-morbidities and associated treatments, previous experiences of the patient with different treatments, personal evaluation by the patient of his quality of life and of the impact on his quality of life of the disease and of the treatments. The goal of the negotiation is to involve the patient in the therapeutic choice. Patient Based Medicine is necessary for the efficient treatment of chronic diseases. Patient Based Medicine is a therapeutic revolution with a strong impact on patient/doctor relationships, medical education, and development of new drugs as well as on the awareness of the rights and the duty of patients.